Is a change in the nevus on lacrimal caruncle melanoma?

Question

Hello doctor,

I have a nevus on my lacrimal caruncle which has been there for almost 10 years. Recently I have noticed a slight change in it. Could it be melanoma?

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern, but I would not advise you to jump into any hasty conclusions. First of all, birthmarks, moles are very common even with the localization that you mentioned. However, to advise you better, it is preferable to compare this lesion on photos taken during these last few years as a marker, keeping in mind that humans undergo many changes as they age. Second of all, it is more advisable to get digital images of this lesion captured by an optometrist or an ophthalmologist through a slit lamp and under magnification for better evaluation. Thirdly, if an ophthalmologist has confirmed your suspicion, a biopsy can be taken from it and sent to histopathology in the assessment at a cellular level, which will clear all doubts completely.

Answer 2

Hello,

Welcome back to icliniq.com.

The caruncle besides conjunctival tissue has hair follicles, sebaceous glands, sweat glands, and accessory lacrimal tissue so I would not advise you to excise it unless it is bothering you. The simple cosmetical surgery should only include excision of the pigmented tissues and not the whole caruncle, which is not out of the question and is directly related to the depth of the pigmentation. Other methods would be to use laser and burn off the pigmented layers which then would heal and should form a layer similar in color to the adjacent structures.